# Digestive system injury

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Blunt Abdominal Trauma - StatPearls (NCBI Bookshelf NBK431087) - https://www.ncbi.nlm.nih.gov/books/NBK431087/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD35 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
DIGESTIVE SYSTEM INJURY
Sources: Blunt Abdominal Trauma - StatPearls (NCBI Bookshelf NBK431087) -
         https://www.ncbi.nlm.nih.gov/books/NBK431087/ · ICPC-3 (WONCA International Classification
         of Primary Care, 3rd edition) class DD35 - condition scope only, no dose · No dose -
         referral pathway, no medicine given in primary care
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (2)
    - The picture is rarely straightforward, so the diagnosis is difficult and takes time
    - Beyond pain, the patient may be bleeding from the back passage  [rectal bleeding]
  SIGNS - what you find (5)
    - Unstable observations, and the signs of peritonitis
    - Look for seat-belt marks across the abdomen and for bruising  [bruising]
    - A distended abdomen, silent bowel sounds, and tenderness on pressing  [abdominal distension]
    - With peritonitis the abdomen goes rigid, with guarding and rebound tenderness  [guarding ·
      rebound tenderness]
    - Bruising around the navel, the Cullen sign, means blood tracking forward from behind the
      peritoneum  [bruising]
  TESTS (12)
    - Take the mechanism, the vehicle speed, deaths at the scene, and alcohol or drug use into
      account, or an injury will be missed
    - Start as with any trauma: airway, breathing, circulation
    - Which test to use turns mainly on whether the circulation is holding up
    - If the circulation is stable, CT of abdomen and pelvis is the test of choice for solid organ
      injury
    - If unstable, use bedside ultrasound or peritoneal lavage, both of which miss injuries and also
      mislead
    - Trauma ultrasound is for blunt or penetrating torso injury with suspected bleeding into the
      belly, tamponade or blood in the chest
    - Right upper quadrant view: free fluid in the space between liver and kidney, the lower kidney
      pole, and under the diaphragm
    - Lying flat, the liver-kidney space is the lowest point, and blood runs there along the right
      gutter
    - Left upper quadrant view: see the whole spleen and the diaphragm, and look above it for fluid
      in the left chest
    - On the left, fluid gathers under the diaphragm rather than beside the kidney, and gas can hide
      that area
    - Pelvic view: fluid collects behind the bladder in men and in the pouch of Douglas in women
    - Lung view: no sliding and no comet-tail artefact means a pneumothorax
  IF NOT THIS - what else fits (7)
    - Domestic violence as the mechanism behind the injury
    - Bleeding stroke
    - Shock from blood or fluid loss
    - Injury to the lower urinary or genital tract
    - A penetrating rather than blunt abdominal injury
    - Trauma in a pregnant woman
    - Injury to the kidneys or upper urinary tract
  Source  StatPearls "Blunt Abdominal Trauma" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Spans minor injuries a GP can manage directly (bitten tongue, chipped/knocked tooth) to
            blunt or penetrating abdominal organ injury that is a surgical emergency; GP gives
            analgesia and wound care for minor injury and recognises which cases need immediate
            emergency referral. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Spans minor injuries a GP can manage directly (bitten tongue, chipped/knocked tooth) to
            blunt or penetrating abdominal organ injury that is a surgical emergency; GP gives
            analgesia and wound care for minor injury and recognises which cases need immediate
            emergency referral.
   Caution  No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - A rigid or distended abdomen, signs of peritonitis, hemodynamic instability,
            a penetrating abdominal wound, or expanding bruising or hematoma: refer immediately.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

---

Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

[Privacy policy](/privacy)